Provider Demographics
NPI:1659633956
Name:GARTLAND, SHARON GAIL (MA, OTR/L)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:GAIL
Last Name:GARTLAND
Suffix:
Gender:F
Credentials:MA, OTR/L
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:GAIL
Other - Last Name:DETWILER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:600 HIGHLAND AVE
Mailing Address - Street 2:MC 2433
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53792
Mailing Address - Country:US
Mailing Address - Phone:608-890-4827
Mailing Address - Fax:608-203-4544
Practice Address - Street 1:600 HIGHLAND AVE
Practice Address - Street 2:MC 2433
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53792
Practice Address - Country:US
Practice Address - Phone:608-890-4827
Practice Address - Fax:608-203-4544
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-12
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4826-26225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics